Written Answers Nos. 601-614
601. Deputy Thomas P. Broughan asked the Minister for Health the cumulative amount of funding removed from his Department and Health Service Executive budgets since 2009, in view of the fact that he recently reported to Dáil Éireann that those budgets are €1.5 billion lower in 2015 than they were up to 2009; and his estimate of the amount of funding necessary to end all waiting lists greater than three months by the end of 2017. [14643/15]
Amharc ar fhreagraAfter accounting for the transfer of Child and Family Services to the Department of Children and Youth Affairs in 2013, the combined reduction in funding to the Department and HSE between 2009 and 2014 amounted to €1.769 billion in gross vote terms. Of this figure, €1.479 billion related to the reduction in funding to the HSE.
Since my appointment as Minister for Health my key priority has been to achieve a realistic budget for health and social care services. Improved 2015 budgetary parameters, reflecting the growing strength of the Irish economy, have enabled me to secure additional funds for the delivery of health and social care services this year. The HSE will have €635 million more available in 2015 than was provided in the original budget for 2014. This is made up of additional Exchequer funding of €305 million and projected once-off revenues of €330 million.
It is not currently possible to estimate with any appropriate degree of accuracy the amount of funding required to end all waiting lists greater than 3 months by the end of 2017. The amount required will be significantly influenced by the implementation this year of plans to address waiting lists in line with the Minister's targets. Only when the impact of the implementation of these plans is clear towards the end of this year will it be reasonable to estimate with an appropriate degree of accuracy the resources that may be required.
602. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the proposed changes to the ambulance services from Dublin Fire Brigade; if he will provide an update on any proposed changes that his Department and local authorities are examining; and if he will provide, in tabular form, the number of ambulances dispatched from fire stations in Dublin during the years 2012 to 2014 and in 2015 to date. [14648/15]
Amharc ar fhreagraHIQA, in its report of December last year, identified serious patient safety concerns over a lack of co-ordination between the Dublin Fire Brigade ambulance service and the National Ambulance Service. The urgent need to address these issues was stressed, particularly for 999/112 call-taking and ambulance dispatch, as well as overall clinical governance.
Following discussions on these issues, the HSE and Dublin City Council agreed in principle to address the weaknesses identified, through the provision of a single point of contact for all emergency calls in Dublin. Under this agreement, all 999/112 ambulance calls for the Dublin region, and the tasking and dispatching of DFB and NAS ambulances, will be from a single centre, the new National Emergency Operations Centre, in Tallaght. In addition, clinical governance of Dublin ambulance services will become the responsibility of the NAS Medical Director. It is important to note that DFB will continue to provide an emergency ambulance service in Dublin. Only the structures around the clinical governance of the service and the management of calls will change under these proposals.
The HSE and Dublin City Council have established a joint implementation group which is currently examining ways to progress the necessary changes over a period of six months. Dublin Fire Brigade staff, through their union, are being fully consulted on these changes and a joint Dublin City Council/Union group has been set up to move the process forward.
With regard to the statistical information sought, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
603. Deputy Thomas P. Broughan asked the Minister for Health his Department's current measures to address access to mental health services for those under 18 years of age; if he will report on the collaborative measures he is taking with the Department of Children and Youth Affairs; and if he will make a statement on the matter. [14649/15]
Amharc ar fhreagraThe HSE has statutory responsibility for the operation of the Child and Adolescent Mental Health Services. There are currently 63 teams in place, which are being reconfigured and expanded, in line with the key priorities in the HSE National Service Plan 2015, and supported from the additional investment for Mental Health Services put in place since 2012.
The HSE waiting list for CAMHS, at February 2015, indicates an overall figure of approximately 3,000 children, of which some 400 are waiting in excess of 12 months. A significant number of children are seen in accordance with targets agreed in the HSE Service Plan for this year. A significant proportion of children on the waiting list are waiting less than three months to be seen. In January 2015, 74 % of children referred were offered an appointment and seen within three months, against the national target of 72%.
It is unacceptable for a child or adolescent to wait longer than 12 months to be seen by a CAMHS team. Direct engagement takes place between the HSE Mental Health Division and all Community Healthcare Organisations (CHOs) on a monthly basis in relation to their performance against agreed performance metrics, including children waiting over one year to be seen. As part of the National CAMHS Service Improvement Project, detailed work has already commenced with CHOs both to review issues affecting performance, and to prepare for the implementation of Standard Operating Procedures for CAMHS.
A targeted approach to addressing child/adolescents on the CAMHS waiting list within the Mental Health Division has also been initiated. All CAMHS Teams have been requested to review lists of children and revert with the contributory factors identified to include detailed action plans agreed to address the lists for each team.
CAMHS teams rate the number of complex cases, the number of emergency cases, and the lack of other services in an area as factors having the greatest impact on capacity to respond to demand. This can in turn lead to less discharges, increased numbers on waiting lists, and longer waiting times for routine assessments. Successive CAMHS reports over a number of years have referred to the many factors that can affect the capacity of a team to respond to the demands placed on it, including referral numbers, administrative/skills mix back-up supports, collaboration with other services such as primary care, TUSLA or school services, and emergency or complex cases arising at particular times.
The collaborative measures referred to by the Deputy are the operational responsibility of front-line agencies delivering children's services. This includes CAMHS working with at-risk children accessing mental health services, and who are also known to TUSLA and the juvenile justice system.
The HSE is currently working in partnership with TUSLA, and co-sponsoring research with NUI Maynooth which is aimed at developing innovative research, building capacity and promoting interagency integration, with a view to developing family-focused mental health services. A CAMHS Community Forensic Team is being developed in 2015 to work with at-risk children accessing mental health services who are known to TUSLA and the juvenile justice systems. This Team will be a precursor to the new 10 bed CAMHS Forensic Inpatient facility being developed as part of the new National Forensic Mental Health Hospital in Portrane, due for completion in 2018. The Team will operate at a national level, liaising with TUSLA and supporting CAMHS nationwide.
The Department of Health is actively engaged with the HSE in relation to monitoring and enhancing all aspects of CAMHS provision over the remainder of this year, as part of the Department's oversight role on the HSE National Service Plan 2015.
604. Deputy Tom Fleming asked the Minister for Health if he will expedite an application for a new hearing aid in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [14663/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
605. Deputy Bernard J. Durkan asked the Minister for Health the extent to which plans and preparations are progressing in respect of the new children’s hospital; the extent to which previous plans costing in the region of €50 million will be superimposed on the new site, thereby making a considerable saving; if, at this stage, the full suite of facilities required have been agreed; if site preparation is advancing; and if he will make a statement on the matter. [14673/15]
Amharc ar fhreagraThe National Paediatric Hospital Development Board is the statutory body responsible for planning, designing, building and equipping the new children's hospital. The new hospital will be co-located with St James's Hospital, and ultimately tri-located with a maternity hospital to be developed on campus. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
The Project Brief, which sets out details of the specialties to be provided and the planned accommodation, has been approved. 384 inpatient beds are planned, all in single en-suite rooms with in-room parent accommodation. There will also be 85 day-care beds and 14 theatres, including three hybrid theatres to facilitate access to imaging during surgery, all in the main hospital. There will be 111 outpatient consulting examination rooms across the main hospital and the two satellite centres, as well as ED and urgent care facilities.
Site surveys and investigations have been completed, decant plans are being progressed, and a design team is working on detailed design development with planning submission scheduled for June 2015. Subject to planning, work is scheduled to commence at the main site at St. James's, and at satellite centre sites at Connolly and Tallaght, in January 2016.
Approximately €39m was spent in the previous phase of this project at the Mater campus. This expenditure is shown in the Board's 2012 accounts, which have been laid before the Oireachtas. Work undertaken for the project on that site, in particular development of activity projections and capacity requirements, development of functional requirements and decisions on workflow, adjacency planning and logistics, has been built on in developing the Project Brief for the hospital in its new location. Minister Howlin has committed to making €200m available from the sale of the National Lottery for the new children's hospital, adding to the existing €450m Exchequer funding and underlining the Government's commitment to the project. Current estimates are that the core hospital, including both satellite centres, will be delivered within this envelope. This includes provision for inflation, VAT and contingencies; it does not include equipment or ICT which can be purchased, licensed or leased separately. Philanthropic and commercial funding streams will be targeted as appropriate for supporting elements of the project to include car parking, academic and research facilities, and estimates will be reviewed and refined at each stage of the project.
606. Deputy Thomas P. Broughan asked the Minister for Health if he will provide, in tabular form, the number of consultant positions vacant in Beaumont Hospital in Dublin 9; the length of time they have been vacant; the effect this is having on waiting lists; the alternatives being offered to patients; and if he will report on progress to fill the positions in an urgent manner. [14680/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
607. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the steps being taken to find the details of how an investigation into home birth practice (details supplied) was undertaken in view of the fact that the removal of professional indemnity to practise effectively closed down the person's practice; and if he will make a statement on the matter. [14684/15]
Amharc ar fhreagraI wish to thank the Deputy for the matter raised.
The HSE is legally obliged to actively promote the well-being, and to protect the welfare, of the public. Decisions in this regard are made on a bona fide basis, based on information available to the HSE at a particular point in time. In relation to the matters raised by the Deputy, the proceedings are ongoing and as such it is not appropriate to comment on a matter currently before the courts.
608. Deputy Tom Fleming asked the Minister for Health if he will examine concerns by the Irish Nurses and Midwives Organisation regarding the urgent need for an appropriate increase in staffing levels at the accident and emergency department in Kerry General Hospital; and if he will make a statement on the matter. [14686/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
609. Deputy Robert Troy asked the Minister for Health the policy that is in place to ensure the benefits of breastfeeding are highlighted to new mothers. [14696/15]
Amharc ar fhreagraThe Department of Health ’s Breastfeeding Strategic Action Plan (2005) has as its mission statement "to improve the nation’s health by ensuring that breastfeeding is the norm for infants and young children". The protective role of breastfeeding extends beyond childhood and is important in the prevention of obesity and chronic diseases in adulthood, including hypertension and diabetes.
A key goal of the Strategic Action Plan is that all families have the knowledge, skills and support to make and carry out informed infant feeding decisions, particularly those least likely to breastfeed.
To achieve this the HSE has a National Breastfeeding Co-ordinator and a multi-disciplinary National Breastfeeding Strategy Implementation Committee oversees the implementation of breastfeeding strategy and initiatives. The National Breastfeeding Strategy Implementation Committee have helped facilitate initiatives such as, evidence based breastfeeding policies implemented across the HSE; improvements in breastfeeding education and training; development of breastfeeding education resources; development of guidelines on supporting and protecting breastfeeding in public places; and the protection of breastfeeding through changes in maternity protection legislation and workplace initiatives.
Staff within HSE maternity and paediatric services and primary care are committed to the promotion, support and protection of breastfeeding. The HSE Infant Feeding Policy for Maternity and Neonatal Services is based on the Baby Friendly 10 Steps to Successful Breastfeeding and is the policy of all 19 maternity units. All 19 maternity units participate in the Baby Friendly Hospital Initiative and there are 8 designated Baby Friendly Hospitals. Breastfeeding is promoted to all expectant mothers in the antenatal period at maternity hospitals and in primary care. Mothers are offered support to breastfeed following birth. Care is provided by public health nurses in the community following discharge from maternity hospital and individualised care plans are developed for mothers. Over 200 breastfeeding support groups are provided by the HSE and HSE funded voluntary breastfeeding organisations around the country.
The HSE launched the first phase of its national breastfeeding campaign ‘Every Breastfeed Baby Makes a Difference’ and promotes an annual National Breastfeeding Week.
The HSE website www.breastfeeding.ie is the primary route for providing information, advice and support to women thinking about breastfeeding and those who are breastfeeding. Feedback from year-round search and display advertising ensures that awareness of the campaign and the invitation to visit the website reaches the target audience.
HSE breastfeeding information materials including the booklet ‘Breastfeeding – a good start in life’ was developed in partnership with Baby Friendly Hospitals Initiative, La Leche League, Association of Lactation Consultants, CUIDIÚ and Friends of Breastfeeding. It forms part of the HSE Healthy Pregnancy Pack which is distributed widely through maternity hospitals and GPs and over 80,000 are distributed annually.
A recent review of the Breastfeeding Strategic Action Plan has highlighted supports being implemented. These include policies to guide good practice and monitoring within HSE maternity services; enhancements in training for public health nurses and midwives; the expansion of appropriately trained community-led peer support programmes; the development of media messages to promote breastfeeding; and the development readily available information including the national breastfeeding website.
610. Deputy Mattie McGrath asked the Minister for Health the constitutional protections currently in place for in vitro embryonic human life; the proposals in place to alter such protections; and if he will make a statement on the matter. [13289/15]
Amharc ar fhreagraArticle 40.3.3 of the Constitution protects the right to life of the unborn “with due regard to the equal right to life of the mother”. However, in Roche v. Roche (2009) the Supreme Court found that three frozen embryos produced during IVF treatment were not considered “unborn” as outlined in the Constitution. The Court ruled that the provisions of Article 40.3.3 only applied following the implantation of an embryo in the womb. Therefore, in vitro embryos do not have constitutional rights under Article 40.3.3 of the Constitution.
Nevertheless, I note from Roche v. Roche that there is a legal requirement to demonstrate respect and dignity towards in vitro embryos. As you are aware, I recently received Government approval to draft a General Scheme of legislative provisions dealing with assisted human reproduction and associated research and I can assure you that dignity and respect will be at the forefront of considerations throughout the drafting process.
611. Deputy Thomas P. Broughan asked the Minister for Health if he will report on mental health services for those under 18 years of age; the number of those under 18 years of age being treated in adult mental health units; and if he will make a statement on the matter. [14405/15]
Amharc ar fhreagraAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
612. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide details of anecdotal reports of those with disabilities discontinuing employment to remain in receipt of a medical card and related care; if he is aware of data relating to such cases; the plans that have been put in place to empower and aid those who wish to stay in employment without the fear of losing a medical card; and if he will make a statement on the matter. [14717/15]
Amharc ar fhreagraI appreciate the importance of the medical card to people with disabilities and the value that is placed on it by the person and their family. I also recognise the importance of employment to people with disabilities and I am committed to supporting the participation of people with disabilities in the social and economic lives of their communities
Many individuals with intellectual, physical or mental health disabilities gain full-time or part-time employment in the open labour market and may still receive health-funded supports on an intermittent or continuing basis, depending on their individual needs and abilities.
Under the relevant legislation, eligibility for a medical card is based primarily on residency and means and not on the basis of having a particular medical condition or disease. The Deputy will be aware of the publication of the Report of the Expert Panel on Medical Need for Medical Card Eligibility and the Medical Card Process Review in November 2014. A key recommendation of the Expert Panel was that a person’s means should remain the main qualifier for a medical card.
However, the Government recognises that the health service needs to be responsive to the circumstances of people with significant medical needs. Following publication of the two reports in November 2014, the Minister for Health and I announced a series of measures to enhance the operation of the medical card scheme and make it more sensitive to people’s needs, especially where serious illness is involved.
Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. Where a person does not qualify for a medical card, they may be provided with a GP Visit Card, appropriate therapy or other community supports or drugs.
613. Deputy Michael Healy-Rae asked the Minister for Health when the new €15 million acute psychiatric unit will open in Cork University Hospital; and if he will make a statement on the matter. [14726/15]
Amharc ar fhreagraAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
